Title: Exploring the impacts of regulations aimed at restricting access to highly hazardous pesticides on suicide and self-harm globally
Overall and aims:
Pesticide self-poisoning is a common method of suicide in low- and middle-income countries. Work involving researchers at the University of Bristol has showcased that banning highly hazardous pesticides (HHPs) leads to significant reductions in pesticide and overall suicide deaths. Based on this work, the WHO are promoting the restriction of HHPs in order to prevent suicide as part of their LIVE LIFE programme.
This recommendation has been based on the implementation of these bans in 5 countries. As the number of countries banning HHPs are increasing it will be informative to understand whether the impact of these bans are similar across settings. Sri Lanka was one of the first countries to introduce bans on HHPs to prevent suicide, and so provides a unique case study to explore what long term impacts bans have on suicide and self-harm rates.
We aim to investigate whether decreases in suicide by pesticide ingestion following bans or sales restrictions of HPPs in Sri Lanka led to a sustained overall decrease of suicide rates and/or an increase in suicide by other methods. We will explore changes in rates of self-harm by pesticide ingestion following these restrictions, as the proportion of people that survive self-poisoning will likely increase when less lethal pesticides are available. We also aim to assess whether bans or sale restrictions of HPPs led to a decrease in the number of pesticide suicides and overall suicide deaths in countries that have recently implemented these changes.
Methods:
Using routinely available data from the Ministry of Health, we will investigate changes in methods of suicide deaths and self-harm in Sri Lanka from 2004 to 2019 in a retrospective observational study. We will also describe any shifts in suicide methods that might have occurred during this time period in males and females and in different age groups.
To assess the effectiveness of changes in regulations to restrict access to HPPs in recent years, we will conduct a systematic review. We will search MEDLINE, PsycINFO and Embase databases for manuscripts documenting the impact of bans and changes in pesticide sales and/or import regulations on the incidence of suicide by pesticide poisoning. Two reviewers will independently screen titles and abstracts for eligibility, and the full text of manuscripts that fit the inclusion criteria. Double data extraction will be performed independently using a proforma developed a priori. Studies that assessed national or small-area bans, or restrictions on sales or imports of one or more pesticide will be eligible for inclusion. We will only include studies that focus on the general population.
Project team:
- University of Bristol, UK: Bruna Rubbo; Duleeka Knipe; David Gunnell; Chris Metcalfe; Lucy Barrass
- University of Edinburgh, UK: Michael Eddleston
Funders/Supporters
This study is funded by the Centre for Pesticide Suicide Prevention, within the University of Edinburgh.
Publications and other outputs:
This study does not currently have any related publications or outputs.
Contact for further details: b.rubbo@bristol.ac.uk; dee.knipe@bristol.ac.uk